Categories of mental illness, it seems, have always been in flux. Owen Davies, as a social historian, draws our attention to the diverse ways in which various societies have categorised certain people on the grounds of insanity. The mad, in the past, were often those that other people found incoherent, over-excited or unduly angry, ideologically or physically dangerous or imbecilic. Such people were often shut away, temporarily or permanently, in asylums. Along with them were incarcerated a range of others who simply did not fit in and no one was sure what to do with them. One later nineteenth-century British study suggested that just 3 per cent of those in asylums were there because of religious anxieties and excitements. Davies's book suggests, however, that such issues were taken particularly seriously by the authorities.
Today, after the closure of many former mental hospitals, all this seems highly troubling. We are open to recognising that one person's belief is another's story, falsehood or fantasy and are less than sure that we fully understand how the mind works. This state of play is built on some awareness of the extraordinary range of scientific and quasi-scientific explanations that − often self-proclaimed − experts have proffered over the last several centuries. For Johan Spurzheim, a doctor who became a leading proponent of phrenology, the answer lay in the variable development of structures in the brain, most specifically the Organ of Marvellousness. This supposedly ‘shaped people's fascination with tales of wonder and miracles’ (p. 17). If enlarged, as he thought it was in the case of John Wesley, it predisposed the patient to religious mania. Such an account needs to be seen in the wider popular context in which Wesley had often been identified by opponents as being a madman who was active in spreading insanity (p. 72).
The core of this study focuses on the ‘age of the asylum’ which Davies dates from the vast expansion of such institutions from the later eighteenth century through to the abandonment of the term ‘asylum’ and its replacement by ‘mental hospital’. This change roughly corresponds to the hundred-year closure rule on patient records. It is challenging not to think about past cases of madness in relation to modern terms such as depression, or schizophrenia, but Davies makes considerable efforts to view historical testimony in its own ideological context. The book is in two parts that are called, respectively, ‘A World of Insanity’, and ‘Inner Lives’. The first provides a tour through a very wide range of psychiatric treatises and other medical and judicial materials. One slight imbalance in the book is that while this section draws its evidence from across Europe (and occasionally North America) the second part is based on a study of case notes from a selection of asylum archives in England, Scotland and Ireland. These mostly give the view of officials writing about their charges but Davies has sometimes been able to supplement these with letters and other more personal materials. The very fact that many of these records relating to often poor and obscure individuals are quite detailed is interesting in itself. Were the mad faithful among the more intriguing and perhaps intractable residents?
Part i begins with an analysis of the way in which psychiatrists, to use that term anachronistically to apply to a diverse range of those interested in the mind (mostly from a non-religious viewpoint), viewed belief in witches and the processes of putting them on trial. Madness was originally thought to have been stirred up by the Devil, as in Jean Bodin's sixteenth-century work on ‘demonmania’ (pp. 18–19), whereas insanity was typically seen in later periods as an explanation for extreme behaviour in its own right. There follows a particularly interesting discussion on the relation of doctors and psychiatrists to the past from an individual's case histories to speculation about historical societies where similar symptoms appeared to be rife. Some of these figures are well-known beyond the circles of specialists, such as Jean-Martin Charcot and Sigmund Freud, but this book usefully highlights the views of a much wider set of writers.
Many such secular-minded thinkers also turned their attention to what they saw as the excesses of contemporary religion, particularly when it took the form of Evangelical revivalism. A chapter explores the degree to which doctors, in apparent contradiction of this, accepted views that we might now think of as spiritual or superstitious. A very interesting section then surveys the reception of supernatural ideas in court. This is relevant because of the ‘not guilty by virtue of insanity’ verdict in English law that was developed by the Criminal Lunatics Act (1800). This legislation was passed in the wake of the pot-shot taken at King George iii by one James Hadfield, who had come under the sway of a self-proclaimed prophet called Bannister Truelock. Killing the king, he declared, would pave the way for the Second Coming. Interestingly, the criminal courts were quite reluctant to find the accused insane and, when doing so, they preferred to decide what beliefs were ‘irrational in relation to societal norms’ as opposed to trusting the views of experts (p. 171). There were related problems in the civil courts, as in an American case concerning Spiritualism where the testator ‘had made provisions in her will following advice from her husband's spirit’ (p. 170).
The case notes that form the core of part ii were sometimes about what had happened before the individuals in question were admitted to an asylum but were more often about what they did and experienced when they were there. This section starts with a chapter on attitudes to aspects of conventional Christianity, such as heaven and hell. This is followed by a discussion of witches and fairies that shows the prevalence of beliefs that officialdom now found archaic and peculiar. The final chapter shows that the products of modern science, such as electricity, trams and the telegraph, could inspire visions and fears in much the same way as aspects of traditional religion. This almost invites a kind of social anthropology that focuses on the function of the belief, rather than its particular content. That approach might shed further light on such fascinating episodes as the ‘strange things that were afoot in the Alpine village of Morzines’ in 1857 (pp. 62–6). There, the modern French state, in the face of apparent mass insanity, intervened by sending in the Inspector General of Insane Asylums and president of the Société medico-psychologique, much as a medieval ruler might have summoned the Inquisition to root out rural heresy.
Davies makes it clear that his interesting book is not a critique of psychiatry, but is ‘primarily a social history of ideas about the supernatural across society through the prism of medical history and its archives’ (p. 9). That notwithstanding, the ghost of Foucault, if I may invoke the supernatural, does still haunt these pages with its warnings that the role of the asylum was to categorise and discipline. Indeed, such thinking, and the ideological relativism of the current book, could be seen in the light of the ‘anti-psychiatric movement’ of the 1960s (p. 53) since the belief systems of the doctors at times appear as difficult and oppressive as those of their patients. While the psychiatric and medical source material is explored in often minute detail, broader distinctions between religion, spirituality, belief, faith and superstition could benefit from a bit more consideration. Likewise, the episodes of interesting discussion of witches and hysteria could have been put in a broader context of the male domination of what was deemed to be expertise. The volume closes with some intriguing thoughts on twenty-first-century conspiracy theories by asking whether those with such beliefs might have been held to be insane in the past. It is the widespread persistence of the irrational that leads Davies to conclude that the giant attempt via the asylum system to ‘foster the right sort of faith’ was a failure both in terms of medicine and of the imagination (p. 278).